Duty to warn about mental status: legal requirements, patient rights, and future ethical challenges
By Elaine Walker, Ph.D.
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Image courtesy to Franchise Opportunities |
This year, legislators in the state of New York proposed a bill that would require physicians to notify the state Department of Motor Vehicles (DMV) about certain medical conditions (e g., seizure disorder, dementia) that might compromise driving ability and endanger public safety. The proposed bill was precipitated by the death of two children who were hit by a car driven by a woman who had a record of previous violations and experienced a seizure at the time of the fatal accident. Lawmakers sponsoring the bill argued that the proposed reporting requirement will help get dangerous drivers off the street. Citizens expressed their agreement by marching in support. Understandably, others responded with concern about increased physician liability, as well as potential violations of patient confidentiality and rights.
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Image courtesy to Nick Youngson, Creative Commons 3 |
The responsibility to warn about public dangers due to patient impairment has been especially challenging in the field of psychiatry. In 1976, the Supreme Court of California (Tarasoff v. Regents of the University of California) ruled that mental health care providers had a legal duty to warn identifiable victims of a patient’s serious threats to harm them. This legislation has been widely recognized in U.S. jurisprudence, and it set the stage for national standards for the responsibilities of mental health professionals. It has also generated a large body of literature concerning the circumstances that give rise to these warnings from professionals. But more recently, the discussion has moved from patients to public figures.
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Image courtesy to Max Pixel, Creative Commons |
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Image courtesy to Max Pixel, Creative Commons |
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Elaine Walker is the Charles Howard Candler Professor of Psychology and Neuroscience at Emory University. She leads a research laboratory that has been funded by the National Institute of Mental Health and private foundations for over 30 years to study risk factors for major mental illness, especially schizophrenia and other psychosis. Her research has focused on both the behavioral and neurobiological factors associated with psychosis risk. In 2007, she was invited by NIMH to form a national consortium with eight other investigators who had been funded to do research in this area. The consortium, The North American Prodrome Longitudinal Study, is the largest prospective study of youth who show clinical signs of risk that has ever been funded by the NIMH. Now, in the 9th year of funding, this multi-site collaborative study is documenting the behavioral, brain, neuroendocrinological and epigenetic, changes that predate psychosis onset.
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Walker, E. (2018). Duty to warn about mental status: legal requirements, patient rights, and future ethical challenges. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2018/11/duty-to-warn-about-mental-status-legal.html